Project Summary: The Aga Khan University/Columbia University (AKU/CU) Global Network Research Unit is applying to continue its membership in the Global Network for Women's and Children's Health Research (Global Network [GN]). At CU, the project is located in the Dept. of OBGYN and at AKU within the Dept. of Community Health Sciences (CHS). To date, our site has been among the most productive in the GN. We have fully participated in all aspects of the GN from developing successful concepts for single site and common protocols to leadership on GN committees. We have acquired non-GN funds both to support GN multisite projects and to strengthen the Dept. of CHS at AKU. We have proven access to large urban and rural populations and have successfully performed hospital-based and community-based studies. We are the only site to have participated in every common protocol. We have contributed more clusters to the GN Registry and cluster-randomized trials than any other site. Our follow-up rates and the quality of our data are excellent. Over the 17 years in the GN, we have enrolled more than 230,000 women and children in GN projects. In the next 5 years, we plan to continue or surpass this level of engagement as detailed below. As part of the GN, we will conduct multi-center trials of interventions for pregnant women, newborns and children to reduce their mortality and morbidity in Pakistan and other low- resource countries. We also plan to continue to maintain a population-based registry of pregnancies and their outcomes in Pakistan, to measure trends and factors associated with those outcomes and to compare risk factors and outcomes to other GN sites. We will continue being a leader among the GN sites in protocol development, subject recruitment, data quality and obtaining outside funding for GN projects and continue to stimulate the development of Pakistani researchers and promote collaborations between AKU researchers and those from CU and other US sites. We will continue to attract new Pakistani and US investigators to global maternal and child health research by systematic mentoring of junior investigators and recruiting senior scientists from related fields, and to continue enhancing the research environment at AKU by providing high-quality administrative, financial, statistical and research support services within a scientifically stimulating multidisciplinary setting. We also will continue to support government endeavors to strengthen the health system in our research site by facilitating training on new cost-effective interventions suitable for countries with limited resources. Because of the many strengths of our research team and its dedication to improving the health of women and children in low-resource settings, as well as its long history of collaboration within the GN and with many entities in Pakistan, we strongly believe that the goals described above will be achieved almost immediately and continue indefinitely, and that the AKU/CU site will continue to be a leader in the GN. As a member of the GN, the AKU/CU site will continue to participate in all aspects of the GN including meeting participation, membership in committees, seeking outside funding, initiating new projects, participating in all studies and using GN data to produce important publications.